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<br />APPLICATION FOR PER!'lIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER <br /> <br /> <br />.J2. <br /> <br />iJll,j J-t}-~~J..fJ.-"'(]; Fi-JJ~:~NE (8/]/ I~YY-- 2 ?-;JP <br /> <br />APPLICANT <br /> <br />ADDRESS <br /> <br />'. <br /> <br />BLOCK <br />77-0 <br /> <br />LOT SIZE_____X AREA SQ. FT. <br />SUBDIVISION ~ ~ /"'1 If!:.. <br /> <br />JOB LOCATION <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />PARCEL I,D,~~ <br /> <br />WORK PROPOSED:____New Construction ----Addition ____Alter.tion ____Repair ____Install <br /> <br />/ D - ;} (,;, - J-/ - I <br /> <br />_Sign/Temp. <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />_M/F <br /> <br />_i~ of Uni ts <br /> <br />._M/H <br /> <br />_commercial <br /> <br />_Indust. <br /> <br />_swim. Pool <br /> <br />Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOR}lS.;'* <br />**COPY OF CONTRACT REQUIRED. <br /> <br />~F.RM1TS RF.OUESTEll <br /> <br />_BUILDING <br />VELECTRICAL <br />/MECHANICAL <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />AMP Service <br /> <br />Florida power Corp. <br /> <br />_____W.R.E,C. <br /> <br />$ <br /> <br />j'i2f-Od <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Frame _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />PONTRACTOR SECTION <br />Company <br />State Cert. or Regist. iF_ <br />City License Registration a <br />****************************************** <br /> <br />lliJ1LDER <br /> <br />Signature <br /> <br /> <br />Company <br />State Cert. or Regist. a <br />City License Registration <br />****************************************** <br /> <br />E -S 0(1000 (P( <br />jF t.f l.f ! <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. iF <br />City License Registration j~ <br />****************************************** <br /> <br />EUlMRF.R <br /> <br />Signature <br /> <br />Company <br />State cere. or Regist. 1F C iJ-c v -"] 11 ~ >- <br />City License Registration # '3 <br />********************************** <br /> <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY ~:;:;~~;~.~~.....~...**.**.*... <br /> <br />Company <br />State Cert. or Regist. a <br />City License Registration a <br /> <br />QTHF.R <br /> <br />PERMIT OFFICER. <br />